Colorado is the first state to make gender affirming health care a mandatory benefit.
Individual and small group health insurance plans, which account for about a quarter of Colorado’s health-care customers, became the first to include gender-affirming care as an essential benefit.
With the help of the federal government, state officials unveiled their new strategy under the federal Centers for Medicare & Medicaid Services (CMS) on Tuesday. The plan includes gender confirmation treatments such as jaw, cheek, and eye alterations, as well as face tightening, facial bone remodeling for facial feminization, breast or chest construction and reductions, and laser hair removal.
CMS Administrator Chiquita Brooks-LaSure called the decision “momentous,” adding that “gender-affirming care can save lives.”
“Regardless of your sexual orientation or gender identity, health care should be accessible, inexpensive, and administered equally to all,” Brooks-LaSure added. “Today’s expansion of Colorado’s essential health benefits to cover gender-affirming surgery and other treatments is a critical step toward guaranteeing equity and access to care for Coloradans,” said the governor. Colorado’s proposal also includes extra health benefits such as an annual mental health exam and greater coverage of opiate alternatives for pain treatment, according to Democratic Governor Jared Polis. According to the Colorado Division of Insurance, there are 15 other medication options, and insurance covers up to six acupuncture visits each year.
Gender-affirming treatment is “another way of characterizing mental and physical health services that assist a transgender person’s body correspond with their gender identification,” according to his office.
CMS granted the state’s request to include gender confirmation care as one of its “essential health benefits,” which are standards set forth in former President Barack Obama’s Affordable Care Act for certain employer plans.
State Medicaid programs are not required by federal law to provide gender-affirming care, but each government can have policies prohibiting particular types of affirmative care or have nothing stated about it.
This creates a “gray area” for trans persons on Medicaid without coverage, according to Christy Mallory, legal director of the Williams Institution, a research institute located at the University of California Los Angeles School of Law. They went on to say that most confirming treatment is “exorbitantly expensive” without insurance, but that by designating the services as essential, they become medically required.
“Those who require this treatment will not only be healthier, but they will also be happier.” This is a condensed version of the information.